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Neodesha�s Medical Scholarship Application
For your convenience, we will copy and submit your application for the following Scholarships.
The Hinrichs Family Scholarship
Jessie and William Post Scholarship
Ruth Stephens Memorial Scholarship Trust
Eunice Swartzleonard Scholarship
Russell Vickers Scholarship
Medical Scholarships are for those students planning to return to the Neodesha area/Wilson County Hospital and include all medical fields:
Nursing, Medical Technology, Physical Therapy and others.
Name____________________________________________________________
Address____________________________________ SS#_________________
Phone [Day]_____________________ [Evening]______________________
High School attended____________________________________________
Year of graduation________________
Post secondary school attended__________________________________
Year of graduation______________________________________________
Name and location of school you will be attending
________________________________________________________________
Field of Study__________________________________________________
Have you applied for this program? ______ Been accepted? _______
Are you currently taking classes? ________ Start date? _________
Expected Graduation date _____________ Degree _________________
How many hours will you enroll in? Fall semester_______________
Spring semester_________________ Summer semester _____________
We understand this will not completely fund your schooling. How
do you plan to fund the rest of your education?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Are there any extenuating financial considerations that should be
considered by the committee?
________________________________________________________________
________________________________________________________________
________________________________________________________________
On a separate sheet of paper, briefly answer the following:
1. Describe your future plans in the healthcare field, including how you intend to use your knowledge in the Wilson County Hospital Network.
2. List your previous work experience. Include employer
name and address, dates of employment and a brief description of your duties and responsibilities.
List any volunteer activities in which you have participated that improved healthcare_____________________________________________
________________________________________________________________
________________________________________________________________
What civic organizations are you a member of, or list civic contributions you have made to your community___________________
________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________
Please provide supporting documentation:
High school and/or college transcripts.
Evidence you have applied to or have been accepted in an accredited healthcare program.
Provide names of 3 references�not family.
Include name, address, and phone number.
Please include a local name, address and telephone number (a family member or friend) who can serve as a long-term contact________
______________________________________________________________
Application deadline--June 1
Wilson County Hospital Foundation Office
P.O. Box 360
Neodesha, KS 66757
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